How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $95.50 Median $131.83 Typical High $169.82 | Facility | None | $95.50 | $131.83 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $169.82 | Professional | None | $131.83 | $131.83 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $512.86 | Facility | None | $257.04 | $257.04 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $169.82 | Professional | None | $67.61 | $83.18 | $169.82 |
CDPHP Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $1,258.93 | Professional | None | $120.23 | $120.23 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $263.03 Median $436.52 Typical High $954.99 | Facility | None | $263.03 | $436.52 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $724.44 | Professional | None | $263.03 | $316.23 | $724.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $102.33 | Facility | None | $85.11 | $85.11 | $102.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $158.49 | Professional | None | $85.11 | $147.91 | $158.49 |
MVP Health Care Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
MVP Health Care Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $446.68 | Professional | None | $158.49 | $257.04 | $446.68 |
United Setting Professional Modifier None Typical Low $109.65 Median $234.42 Typical High $363.08 | Professional | None | $109.65 | $234.42 | $363.08 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $147.91 Typical High $147.91 | Facility | None | $85.11 | $147.91 | $147.91 |
Univera Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $158.49 | Professional | None | $85.11 | $147.91 | $158.49 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $25.70 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $16.98 |
Where New York sits
The same service costs 3.3 times more in Iowa than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 51st of 51
$85.11
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.